The Effect of Salsalate on Glucose Homeostasis

Presentation Number: SUN 636
Date of Presentation: April 2nd, 2017

Julie Zaidan*1, Allison B. Goldfine2, Taha Elseaidy3, Osama Hamdy4 and Joanna Mitri5
1staten island university hospital, Staten Island, NY, 2Research Division, Joslin Diabetes Center, Boston, MA, 3University of Massachusetts Boston, boston, 4Joslin Diabetes Center, Boston, MA, 5St. Annne's Hospital-fall river, Providence, RI

Abstract

Evidence is accumulating that salsalate treatment improves glucose homeostasis. The aim of this study is to evaluate the effect of salsalate on glycemia.

We searched PubMed for randomized trials looking at the effect of salsalate on glycemia in adults. A MEDLINE search from January 1950 to November 2016 was undertaken using: salsalate (diabetes, obesity). Only randomized, placebo-controlled studies evaluating salsalate versus placebo were included. Meta-analyses were performed for differences on fasting plasma glucose (FPG) (mmol/l) and hemoglobin A1C (A1C) (%) between baseline and end of study. The outcome was calculated as standardized mean difference (SMD) with 95% confidence interval (CI). The quality of the studies was determined by the Jadad score. The random effects model was used to calculate the combined outcome. Heterogeneity was assessed by the I2statistic. Publication bias was assessed by the trim-and-fill analysis. Literature search, data gathering and quality assessment were performed independently by 2 investigators. All graphs and calculations were obtained using Comprehensive Meta-Analysis version 2 (Biostat, Englewood, NJ).

We included 9 studies (N=933) reporting on fasting FPG or A1C. Salsalate dose ranged from 3 to 4.5 g per day. Study duration ranged from 4 to 120 weeks. Out of 9 studies, 9 were double blinded and 1 was single blinded. Jadad score ranged between 3-5. Salsalate therapy was associated with a greater decrease in the SMD for FPG than placebo with SMD -0.58 (95% CI –0.76 to -0.41; p<0.001). Heterogeneity was moderate with I2=30% (p=0.16). Sensitivity analyses by removing one study at a time showed no bias. There was publication bias. By adjusting for the 4 imputed studies, the difference remains significant SMD: -0.47 (95% CI -0.67 to -0.27). Salsalate was also associated with a greater reduction on the SMD for hemoglobin A1c than placebo with SMD -0.47 (95% CI -0.66 to -0.27; p<0.001). Heterogeneity was low with I2=20%., p=0.27. Sensitivity analysis showed no bias. There was no publication bias

Salsalate seems to have a positive effect on glycemia, Salsalate has been marketed for pain relief for decades. One must consider these glycemic benefits in relation to potential risks. Larger randomized controlled trials are needed to look at which population might benefit the most.

 

Disclosure: OH: Researcher, national dairy council, Researcher, HealthMation, Researcher, Merck & Co., Researcher, Abbott Laboratories. JM: Researcher, research support from dairy council. Nothing to Disclose: JZ, ABG, TE